BTW I am 33 months out from DaVinci at City of Hope. Pre-op psa was 4.0, gleason 3+4. All went well except for a + margin. No continece or ED issues. Post-op psa's have all been <0.1. Most recently I had a more sensitive test and results came back at psa <0.03 and free psa 45%. I know that free psa has diagnostic value prior to treatment, just curious as to whether it is indicative of anything after. Thanks in advance for your input.

I would like to read the responses to jmon's question about the significance of free PSA after an RP...anyone know the answer? or does anyone have a cited article or study regarding this subject? I know free PSA is available in the blood but what does the free PSA percentage show in the case of a man who has undergone an RP. Should it be a very low percentage figure or what...I don't know...anyone out there know...Age 75 at DX 76 on 9 May 08DRE positive with nodule 15 Jan 08PSA 3.8 18 Jan 08Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.Bone scan and CT scan Negative 12 Mar 08Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.- - - - - - - - da Vinci successfully completed by Dr Fagin as scheduled.Path Report:Gleason downgraded to 3+4=7Tumors confined to the prostate.Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.Margins Negative.Extraprostatic Extension NegativeSeminal Vesicle Invasion NegativeStage pT2cAs far as it goes between you, me and the fence post I am cured. But I am required to keep an eye out for the PSA due toward the end of June.

which indicates that free PSA hasn't any significance regarding prediction of recurrent cancer. I wonder why doctors want a free PSA done anyway. I just got a prescription from my doctors office regarding my upcoming PSA test on 24 June and they ask for "free and total PSA." Its puzzling to say the least.

Age 75 at DX 76 on 9 May 08DRE positive with nodule 15 Jan 08PSA 3.8 18 Jan 08Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.Bone scan and CT scan Negative 12 Mar 08Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.- - - - - - - - da Vinci successfully completed by Dr Fagin as scheduled.Path Report:Gleason downgraded to 3+4=7Tumors confined to the prostate.Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.Margins Negative.Extraprostatic Extension NegativeSeminal Vesicle Invasion NegativeStage pT2cAs far as it goes between you, me and the fence post I am cured. But I am required to keep an eye out for the PSA due toward the end of June.

Thanks for the responses. TC, my doc was Kawachi but after the initial post-op catheter out/pathology report I haven't been back. I live in Orange County so use my local gp for psa tests.

Since my op in '05 all of the psa tests I had gotten were not ultra-sensetive and all came back <0.1. Recently I was at another doc trying to make a plan to get my hereditary cholesterol under control and mentioned that I was due for a psa test so he threw it in with the other blood work he was requesting. Unbeknown to me it was a 2nd generation test which is sensitive down to 0.03. My results came back at <0.03 and <0.01 free psa. Needless to say I was very happy. I'm coming up on my 3 year operation anniversary in which I had positive margins. I asked Kawachi about adjuvant radiation and he said, "I wouldn't. Just go home and live your life and keep an eye on your psa." All this time I have been thinking I should be getting ultra sensitive tests in case there was a trend upward. But on the other hand I was going with "ignorance is bliss", all the while sweating that one of my tests would pop up over 0.1. So when this latest 2nd gen test got dropped on me by surprise it was like 3 years of concern just melted away.

Anyway back to my original question. That last test included free psa and I can't seem to find anything about the significance of post-op free psa. I've read the article you forwarded TC. It doesn't really answer the question.

Salty, I can't seem to open the link you sent but I'll try another way around.

Anyway thanks for the responses and good luck to us all as we battle this nasty b**tard.

Sorry you couldn't open the article jmon...I just reopened it using cut and paste.Great numbers you got on your PSA, free and total. I guess the lower the percentage in both free and total is the desired goal and you seemed to have hit it....very good.Age 75 at DX 76 on 9 May 08DRE positive with nodule 15 Jan 08PSA 3.8 18 Jan 08Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.Bone scan and CT scan Negative 12 Mar 08Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.- - - - - - - - da Vinci successfully completed by Dr Fagin as scheduled.Path Report:Gleason downgraded to 3+4=7Tumors confined to the prostate.Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.Margins Negative.Extraprostatic Extension NegativeSeminal Vesicle Invasion NegativeStage pT2cAs far as it goes between you, me and the fence post I am cured. But I am required to keep an eye out for the PSA due toward the end of June.